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Alex Fulton
Alex Fulton has been working in the wellness field for more than 20 years. She has written extensively about integrative medicine, herbalism, supplements and other topics related to holistic health. Alex also focuses on issues related to women's health, from menstruation to menopause. She has collaborated with physicians, midwives and functional medicine practitioners to promote natural approaches to health care for women. She has a BA in English from the University of Wisconsin-Madison.
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Clinically Speaking: Questions to Ask Your Healthcare Provider About Head and Neck Cancer
If you've received a head and neck cancer diagnosis, here are some important questions to ask your healthcare provider.
Apr 27, 2021
Created With Support Medically Reviewed
If you've recently received a diagnosis of head and neck cancer, you may be feeling overwhelmed and unsure about what to do next. HealthyWomen asked Eleni Rettig, M.D., a head and neck surgeon at Brigham and Women's Hospital and Dana-Farber Cancer Institute at Harvard Medical School, to suggest questions you should ask your healthcare provider about head and neck cancer.
What type of head and neck cancer do I have?
Why this question is important:
There are a number of types of head and neck cancer, including those in the throat, voice box, mouth and lips. It's important to understand which type of cancer you have because each one has unique considerations for treatment and prognosis and may be managed by different teams of specialists.
Is this cancer hereditary?
Why this question is important:
While some head and neck cancers may have a genetic component, very few of them are hereditary. It's important to know whether your cancer is hereditary so you can determine whether your family members may also be at risk and whether you should get additional testing.
Was my cancer caused by HPV?
Why this questions is important:
Rettig said people with cancer of the oropharynx, which includes the tonsils and back of the tongue, need to know whether their cancer is caused by the human papillomavirus, or HPV. "HPV-positive oropharynx cancers have a better prognosis than HPV-negative cancers," Rettig said.
Will my treatment be specific to my HPV status?
Why this question is important:
Right now the treatment for oropharynx cancer is the same regardless of HPV tumor status, but there are many clinical trials underway to determine whether HPV-positive oropharynx can be safely managed with less treatment than what is given for HPV-negative cancers.
What are my treatment options?
Why this question is important:
Treatment options — which include surgery, radiation and chemotherapy — are different for each person and are based on factors such as their individual health, what type of tumor they have and what stage the cancer is in.
New ways of treating head and neck cancer are also being studied; these include precision medicine, where a treatment is specifically designed for a person's cancer, and immunotherapy, which activates the immune system to target cancer cells.
What are the side effects of treatment?
Why this question is important:
Side effects of head and neck cancer are very different for each patient, so it's important to ask your doctors what to expect in your particular situation.
"Depending on which treatment you have, side effects and their effect on your quality of life can range from minimal to severe. If you have extensive surgery and/or radiation, you may experience changes in your speech, swallowing and even appearance," Rettig said.
What is the survival rate of this cancer?
Why this question is important:
Factors that affect survival of head and neck cancer include the type of cancer, stage of the disease and, for oropharynx cancers, the HPV status of the tumor.
"Asking about average survival rates can give you a general sense for your prognosis, but it is also important to remember that each patient's experience is unique," Rettig said.
If I haven’t been vaccinated already, should I still consider the HPV vaccine after diagnosis or treatment?
Why this question is important:
The HPV vaccine available in the United States protects against nine types of HPV infection. If you've already been treated for HPV-positive cancer, getting the vaccine will not have an effect on the course of that particular cancer. However, it could protect you against a new infection from other types of HPV that you haven't been exposed to yet.
What specialists do I need to contact?
Why this question is important:
Rettig suggested asking your doctor to recommend a head and neck oncology practice, which typically includes a surgeon, radiation oncologist and medical oncologist. Finding the right specialists is important because they have specialized knowledge and are better equipped to meet your specific treatment needs.
What support services and resources are available to me and my loved ones?
Why this question is important:
Since caring for a loved one with cancer can be emotionally and physically draining, friends and family who will be helping you through your treatment may want to seek out a support group for caregivers.
Rettig pointed to Support for People with Oral and Head and Neck Cancer, a national support organization, and the American Head & Neck Society as great sources of support and information.
This resource was created with support from Merck.
From Your Site Articles
- Fast Facts: What You Need to Know About Head and Neck Cancer ›
- Understanding Head and Neck Cancer ›
- Coping With the Emotional Impact of Head and Neck Cancer - HealthyWomen ›
- Ask the Expert: Head and Neck Cancer - HealthyWomen ›
- Reduce the Risk of Head and Neck Cancers - HealthyWomen ›
- Symptoms of Head and Neck Cancer - HealthyWomen ›
- Locations of Head and Neck Cancer - HealthyWomen ›
- True or False: Head and Neck Cancers ›
- Verdadero o falso: Cánceres de cabeza y cuello - HealthyWomen ›
- Managing Side Effects of Head and Neck Cancer Treatments - HealthyWomen ›
- Ubicaciones del cáncer de cabeza y cuello - HealthyWomen ›
- SÃntomas de cáncer de cabeza y cuello - HealthyWomen ›
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Age is just a number. But it’s an important factor when it comes to your bone health.
Everyone loses bone mass as we age, but women are at higher risk for osteoporosis — a condition that causes bones to become thin and weak — compared to men. With osteoporosis, something as simple as a sneeze can cause bones to break and seriously affect your quality of life and overall health.
Osteoporosis gets worse over time, but early management of your bone health can help keep your bones strong.
Thankfully, a simple imaging test called a DEXA scan can tell you everything you need to know about your bone health.
We know it can be a pain to add another test to the long list of health check-ups. But talk to your healthcare provider (HCP) about a DEXA scan if you have risk factors such as low body weight, a family history of osteoporosis, a history of fractures or health conditions that may impact bone health. And all women 65 and older should get a DEXA scan to screen for osteoporosis.
Here’s what you need to know about DEXA scans and what your test results mean for your health.
Read: A Guide to Medical Imaging for Women >>
What is a DEXA scan and what does it measure?
A dual-energy X-ray absorptiometry (DEXA) scan looks at bone density. The non-invasive test uses a high- and low-energy X-ray beam to measure calcium and other minerals in your bones.
DEXA scans have the ability to show brittle, weak and thinning bones among other changes, which can help diagnose, manage and treat health conditions like osteoporosis.
What is a T-score?
Your DEXA scan results are given as scores: T-scores or Z-scores.
If you’re postmenopause, your results will be a T-score.
The T-score is the difference between your bone mineral density and the number zero, which represents the bone mineral density of a healthy young adult.
What does a T-score mean?
Basically, the lower your T-score, the higher your risk of breaking a bone and bone fractures.
A T-score of:
- -1 or higher is normal bone density
- -1 to -2.4 is low bone density, which means you may be at risk for osteoporosis
- -2.5 or less means you may have osteoporosis
What is a Z-score?
For people in perimenopause and younger, a Z-score is used to compare bone mineral density to people who are the same age, weight, sex, race and ethnicity.
What does a Z-score mean?
A Z-score of -2 or less means you have lower bone density than other people your age.
A low score could mean that you are losing bone mass more quickly than others your age or that you have osteoporosis that’s caused by a health condition or medications.
What to do if your T-score or Z-score is low?
If your T-score or Z-score is low, the first thing to do is talk to your HCP about your results and discuss steps moving forward that can help prevent further bone loss.
Your treatment plan may include taking prescription medications or follow-up testing to confirm a diagnosis or determine what’s causing low bone density. Depending on your results, your HCP may refer you to an osteoporosis specialist.
Also, lifestyle factors such as exercise and weight training and adding calcium and vitamin D to your diet may be recommended to help prevent loss.
How often should you get a DEXA scan?
Most people who are at moderate risk for osteoporosis should get a DEXA scan every three to five years. And people who are at high risk for osteoporosis should get a scan every two years.
Depending on your score and treatment plan, your HCP may want to do a follow-up DEXA test sooner than what’s recommended to see how your treatment plan is working.
Either way, understanding your T-score or Z-score is a win for Team Bone Health.
This educational resource was created with support from UCB, a HealthyWomen Corporate Advisory Council member.
Alex Fulton
Alex Fulton has been working in the wellness field for more than 20 years. She has written extensively about integrative medicine, herbalism, supplements and other topics related to holistic health. Alex also focuses on issues related to women's health, from menstruation to menopause. She has collaborated with physicians, midwives and functional medicine practitioners to promote natural approaches to health care for women. She has a BA in English from the University of Wisconsin-Madison.
Medically reviewed by Jennifer Grandis, M.D.